#1A
Revised 7/9/2019
State of New Jersey
Department of Children and Families
Office of Human Resources
Employment Area of Interest Form
INSTRUCTIONS: Please choose up to three counties and put them in order of preference below
County #1 ____________________ County #2 ____________________ County #3 ____________________
By signing this form, I acknowledge that if I am offered an interview or position and I decline in any of the counties I have
selected above, my name will be removed from the hiring list. I further understand that once my name is removed, I
will be required to wait three (3) years before I can re-apply to be considered for future positions.
Special Note for Family Services Specialist Trainee: I am aware that if hired, I am unable to transfer to another Local
Office until I achieve permanent status as a Family Service Specialist 2, which may take up to one year and six months
after my date of hire. Transfers are not guaranteed.
Special Note for Assistant Family Service Worker 1: I am aware that if hired, I am unable to transfer to another Local
Office until I achieve permanent status, which may take up to four to six months after my date of hire. Transfers are not
guaranteed.
Applicant’s Name (please print): _______________________________________________________________
Applicant’s Signature: _________________________________________________ Date: _________________
